Recent years have brought an endless stream of rules, regulations, and demands from governments, doctors, and pharmacies meant to battle the evils of opiate addiction. What was once between a chronic pain sufferer and his primary care physician is now a multi-person group fuck. I don’t blame doctors or pharmacists. Government has forced upon them numerous rules that make it harder and harder for chronic pain sufferers to receive relief.
I am required to see my primary care doctor every three months to continue to receive narcotic medications. I currently take Vicodin (Hydrocodone), five tablets per day. Three scripts at a time are sent to the pharmacy. I can’t fill the prescriptions early. They must be filled on the day listed on the script. This means you are typically out of medication on the day you fill your prescription. Of course, if you don’t get to the pharmacy at the right time or they are OUT of your medication, you are screwed. Long-term narcotic pain meds users are not addicts. They are, however, physically dependent on narcotics. When pain medications are suddenly stopped, the patient goes through horrific withdrawals.
Last year, the pharmacy I use was out of Vicodin. Well not “out.” They had enough of the drug to give me a partial fill, but according to the pharmacist, CVS was not permitted to give patients partial fills for narcotics.
“Fine. Please transfer my prescription to another pharmacy.”
“I’m sorry, but we are not allowed to do that either.”
“You do know what happens if I suddenly stop taking Vicodin”?
“I understand, but there’s nothing I can do. We won’t have any Vicodin until Wednesday (four days).”
This was on a Saturday. My prescribing doctor was out of town until Monday. I knew calling the on-call doctor was a waste of time. He would think I was a drug-seeking addict.
Fortunately, I only went without Vicodin for thirty-six hours. I borrowed some Percoset from a dear friend of mine to tide myself over. Of course, doing so was a crime. On Monday, my primary care doctor was able to fix the problem for me by sending the script to a different pharmacy.
Keep in mind ALL narcotic prescriptions are tracked with software. All doctors and pharmacists have access to this system. It is IMPOSSIBLE to abuse legally prescribed narcotics. I can’t think of one way a patient can game the system. Scripts are no longer handwritten. They are transmitted digitally, straight to the pharmacy. The prescriptions can’t be filled early. There’s simply no way for me to abuse the narcotics I take five times time a day. Yet, here I sit tonight, unable to fill my August 8th prescription until August 13th.
My doctor prescribes me a thirty-day prescription of one-hundred-fifty tablets every twenty-nine days. This means I have an extra five tablets each month. Five. Not twenty. Not fifty. Five. These five tablets provided me a monthly buffer in case of a pharmacy problem or I have a really, really, really, really, really bad pain day. Five tablets. Unbeknownst to me, the pharmacy was tracking these five extra tablets, and today was the magic day when they decided to bring the hammer down on me.
The pharmacy will not automatically fill a narcotics refill. Even though my doctor digitally sends the script to them, I must call them to have it filled. That’s what I did today, only to find out that they would not fill my prescription until August thirteenth. Five days of no medication. I have nine tablets on hand, so I have to cut my medication by seventy-five percent — two tablets a day. Why? Five tablets. Five tablets each month for six months is thirty tablets, the pharmacist informed me. I tried to explain things to her, but it mattered not. All she saw is what she called a “retention issue.” Those tablets I “retained” were actually used when needed. Long-term chronic pain sufferers learn to manage their narcotic meds, adapting usage to pain levels. None of this matters. Fundamentalism rules supreme when it comes to prescribing pain medications. “These are the rules. Obey. Don’t obey, we will punish you.”
Will the War on Chronic Pain Sufferers Ever End? I ask in the title of this post. Death, that’s what will put an end to this pernicious war against chronic pain sufferers. Patients who have their medications suddenly cut off have a higher risk of suicide. Despair sets in when you think, and often know, no one is listening to you. Allegedly, the goal of the medical profession is to alleviate pain and suffering. My primary care doctor had that as his goal when I first started seeing him twenty-seven years ago. And he still does today. The only difference, of course, is that twenty-seven years ago no one stood between us. Today, the FDA, the state of Ohio, pharmacies, pharmacists, and insurance companies stand between us, materially affecting the prime directive: alleviate pain and suffering.
It remains to be seen how the next five days will go. Polly is fearful that I might kill myself, but I told her as she left for work, “Don’t worry. I’m fine.” She asked me “Why aren’t you more upset over this?” I replied, “I have no control over any of this. None! Yes, I am angry, beyond angry, but all the rage in the world won’t change the fact that my prescription will NOT be filled until August thirteenth.”
My singular goal is to make it to the thirteenth. Will one tablet every twelve hours, lots of Tylenol, and aspirin be enough to stave off the worst of withdrawal? I doubt it, but what else can I do? Maybe drink Jamison for breakfast, lunch, and dinner?
I plan to take a drive to Michigan where marijuana is legalized. According to state law, I can’t legally buy cannabis, but Michigan dispensaries will sell it to Ohio residents. Rumor has it that the Ohio sheriff’s departments that border Michigan — particularly Williams and Fulton — are using off-book undercover officers to write down the license plate numbers of Ohio residents who dare to visit Michigan dispensaries. Yes, indeed. Crimes of the century are taking place just over the state line.
Writing helps distract my mind from my ever-present pain, so if you see a flurry of new posts, you will know why.
Bruce Gerencser, 67, lives in rural Northwest Ohio with his wife of 46 years. He and his wife have six grown children and thirteen grandchildren. Bruce pastored Evangelical churches for twenty-five years in Ohio, Texas, and Michigan. Bruce left the ministry in 2005, and in 2008 he left Christianity. Bruce is now a humanist and an atheist.
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I’m so sorry Bruce. You know, I once mentioned I took Kratom for pain to my health care practitioner, and they accused me of getting addicted. Except I can forget to take it. So now I’m not saying a thing. And if I ever get marijuana, I probably won’t tell my health care providers I’m taking that either.
You know, I wonder if it would be possible for someone to take a scenic drive over to NE Indiana, and continue with a scenic ride to a Michigan dispensary and back. Which could be a pain but hey, any way to thwart the cops.
Good luck, Bruce!
No, the war on pain sufferers will never end. It comes from the puritanism of Christianity.
Neil—I was thinking the same thing as I read Bruce’s post.
The puritanical right-wing regimes are basically trying to eliminate any sort of medical care that makes medical conditions bearable and improves the quality of life for anyone who doesn’t fit their notions of what “God intended.” So what Bruce and other chronic pain sufferers are experiencing is of a piece with all of the attempts to eliminate abortion (and much else in women’s health care), transgender people and anything that makes people more aware of the truth about their bodies, themselves and their histories (personal as well as collective).
Bruce—I wish I knew how to ease your pain. All I know is that all of the prayers and Bible thumping in the world don’t help.
Actually, this is even truer than most people understand. Andrew Monteith has just published a book titled “Christian Nationalism and the War on Drugs.” Monteith believes the war on drugs and pain sufferers as well as those abusing drugs to the influence of Frances Willard and the Protestant Christian Temperance movement. Racism also had a lot to do with it too as scare stories about African American people using opioids, cocaine, or marijuana were common fare in the late 19th and early 20th century newspapers. “Reefer Madness” helped to spread misconceptions around marijuana.
Someone close to me lives with chronic pain and encounters the same problems. All of the laws seem to put the greatest burden on people using the drugs under doctors orders, in fact they seem to be designed to target people who rely on these drugs.
I am sorry you have to suffer through this. I do hear that Michigan is nice this time of year.
What BJW said. If you were ever curious about Kratom….
It hurt my soul to read this. You don’t deserve the condescending doctors, or to a victim of a system that thinks chronic pain suffers are only in it for the drugs. The whole system is a messed up, sick joke.
In the words of the Reverend Wright – “Not God bless America, God damn America!” You have to fight this on a weekly / monthly basis – I have only experienced this once, a few years ago, and I am still pissed.
I am sorry you’re going through this. It’s a draconian punishment of innocent people who need these medications, not thoroughly thought out to protect the people who need the drugs. This is one of the problems I have with legislators – they’re often voting on things about which they have zero expertise but have serious repercussions.
I could probably get you what you need, but getting it there before the 13th is unlikely anyway. I’m truly sorry.
This b.s. makes me beyond livid.
Bruce, I am sorry that you experience these problems at getting your legitimate prescriptions refilled. Much of this comes from confusing people who legitimately need pain control with people who may be misusing opioids. There has to be a better way for dealing with controlled substances that does not include treating people who use opioids for legitimate medical issues as potential criminals. We can and should do better as a nation.
Bruce, I was in excruciating ischemic pain for 18 months and got the same rigamarole you describe. The opiate abuse crackdown caused legitimately needy persons to be default treated as potential abusers even by our Doctors trying to avoid trouble with the Feds. I used plain un-buffered morphine tablets which provided the most relief for the dose. Taking the next pill only as pain returned, I eventually tapered off. I never craved it so addiction was never an issue with morphine. Big pharma pushes high profit stuff that drives addiction problems. Morphine is generic, not big profit, won’t damage your liver, and for me not addictive. Currently I am pain free and use 5 mg of edible cannabis before bed for sleep. It’s available here in CA w/o a scrip. I’d go to MI & get what I need. I’d study a couple of lawyer videos on the subject of fishing expedition traffic stops and probable cause. Worst case scenario if you get stopped, decline politely to answer questions and politely decline a vehicle search. The best response I know to questions asked at a fishing stop, Is “Why do you ask?”.
“Where are you coming from today sir?” “Why do you ask officer?” Followed by “I’d rather not say”. The response to a request to search is “Why?” and if they offer a reason to search, “No. Thank you”. Just go Bruce. You wouldn’t arouse any rational suspicions.
I’m only able to send my sympathy–I wish I could send actual help.
The medical system in this country can be so awful.
I’m sorry to hear you are suffering. I wish I could send you some marijuana from Colorado, but it’s so expensive. If I were you, I might try to go to Michigan. Cops do profile, and an elderly white couple is less likely to be stopped. If you are stopped, you do not have to consent to a search. My brother is a lawyer, he told me this. They would then have to decide if it’s worth it to detain you while they call a judge. Considering you look like a sweet grandpa, they probably won’t do it. Holding an ill, elderly man in the heat of August isn’t a good PR move for the cops or the state. Lots of people travel to Colorado for pot, and never have a problem. Cops have better things to do than check everybody’s gummy bears.
Bruce, I join with others in sadness at your troubles.
I’m glad you find distraction and comfort in writing.
You must know that you also provide for us.
You are a source of insight and wisdom.
For that, and for many reasons, you are valued.
I’m not the only one hoping you are with us for a long, long time.
No, the war on chronic pain will not end in this country–at least not in my lifetime. I’m now spending an extra $2,000 a year for “concierge medicine,” because my doctor is semi-retired, and part of a pay-to-play plan–which money I will scrape together because I have to find a new doctor, otherwise. He has been my doctor for 20+ years, and we trust each other. He knows I’m not an addict, and fills my prescription requests promptly, bless him. I see him every three months, usually just a check-in with lab work, unless I’m actually sick.
My other choice was to find a new doctor within the practice (for insurance reasons), explain my arthritis problems, and hope he/she understood. If not, I’d be treated like a drug-seeking addict, watched like a hawk, treated like a potential criminal, and have to find yet another doctor. Chronic pain is miserable, and I don’t need to go through that, if I can avoid it.
I’m so sorry Bruce. It’s so unfair. I hope we can get legislators into office who will introduce more humane and enlightened policies.
The pain I have is nothing like yours. I have carpal tunnel in the wrists which causes weird pin-prick sensations in the hands usually when trying to get to sleep. I also recently strained a leg muscle and have been taking non-prescription ibuprofen for that.
I cannot drive a car because of epilepsy so my husband takes me to doctor’s appointments and everywhere else I need to go when I cannot take public transportation. I cannot imagine what it would be like if I did not have him.
WE NEED TO STOP TREATING PATIENTS LIKE CRIMINALS. I have my own tales for what I have experienced because of epilepsy, carpal tunnel, etc.but they are nothing like your problems, I am sorry.
In Colorado marijuana is legal I wish there were a way I could get this to you.
People like me need people like you who can create websites to see that our problems are not unique if we are atheist etc.
Take care of yourself as your first priority. You have already given me a lot.
If I may Bruce, I’d like to quote from this post for a post of my own.
So much of the problem started with the Sackler brothers and their lies. OxyContin, the prescribing information when that stuff first came out said to dose the patient every 12 hours and if they complained of pain before the 12 hour mark to INCREASE the dose, not the frequency, they knew their shit wouldn’t last 12 hours, this was a set up to create more prescriptions, to hell with the fact that it’s a sure road to addiction for most people.
Then they turned science on its head, telling prescribers that if a patient was truly in pain they wouldn’t get addicted. It’s not nearly so simple. If someone is in acute pain, say from surgery or a broken bone, prescribers were giving them a 30 day supply when any acute pain will, and should be gone by 30 days. However nobody accounts for the fact that the patient who broke her ankle is also way stressed, she has 3 young children, she’s going to loose her job and the oxyhaze is a better place to be. And now…she’s on the merry-go-round.
Most of the time addiction is not on the radar of people with cancer. It shouldn’t be. But when we treat chronic pain sufferers like they’re suddenly going to turn into addicts we prove that we still don’t really understand the difference between dependency and addiction. Yes Bruce is dependent on narcotics, Being in pain is a dreadful way to live, but addiction, you don’t see him ramping up his dose, you don’t see ER visits with different subjective complaints. You see a man, in a wheelchair having a tough time getting through the day. A man who isn’t allowed to have a few extra pain pills on hand to get him past a roadblock the system created.
Absent pharmacy tomfoolery, running out of med earlier each month is a sign of a problem, which is why they have such a chokehold on the meds, they seem to think it will stop people boarding the merry-go-round. It won’t. What will stop it is treating mental health the same as physical health. That’s one thing, the other thing is to actually run medical rules, laws and regulations across a rotating panel of actually practicing physicians, allowing them to mandate real world changes to pie in the sky or siloed rules that conflict with common sense. Most doctors don’t wind up on jury panels, they could fulfill their jury duty on this panel.
Cue the house whine
“But that would make SENSE!”